RESUMEN
Abstract. Several approaches to the rehabilitation of agrammatism use implicit and explicit learning methods. Objective: To verify the effect of adapted Mapping Therapy and ORLA methods (explicit versus implicit learning) on the oral and written production in spontaneous language among agrammatic patients with Broca's aphasia. Methods: Six individuals were submitted to Mapping Therapy and ORLA (Oral Reading for Language in Aphasia) treatments. Samples of oral and written production from a picture description task were compared pre and post-treatment. Results: In Mapping Therapy, the patients presented better performance after the training for the variables related to written production: number of words, nouns, verbs, closed-class words, and number of complete sentences. Regarding oral output, the patients had similar performance before and after the therapeutic process. In ORLA, the patients presented a significant difference before and after the therapeutic process in the variables related to oral production, increasing the number of words, number of verbs, and speech rate. There was no difference in pre and post-treatment performance in written production. Conclusion: Both implicit and explicit learning can be used in the treatment of agrammatism. Mapping Therapy was more effective for the treatment of agrammatism in written production, while ORLA was more effective for the agrammatism in oral production.
Resumo. Várias abordagens terapêuticas para a reabilitação do agramatismo utilizam métodos implícitos e explícitos de aprendizado. Objetivo: Verificar o efeito dos métodos adaptados Mapping Therapy e ORLA (aprendizagem explícita versus implícita) na produção oral e escrita de discurso em pacientes agramáticos com afasia de Broca. Métodos: Seis indivíduos foram submetidos aos tratamentos Mapping Therapy e ORLA. Amostras das produções oral e escrita na tarefa de descrição da prancha foram comparadas antes e após o tratamento. Resultados: No método Mapping Therapy, os pacientes apresentaram melhor desempenho após o tratamento nas seguintes variáveis relacionadas à produção escrita: número de palavras, substantivos, verbos, palavras de classe fechada e número de frases completas. Em relação à emissão oral, os pacientes mantiveram desempenho semelhante pré e pós processo terapêutico. No método ORLA, os pacientes apresentaram diferença significativa antes e após o processo terapêutico nas variáveis relacionadas à produção oral, com aumento no número de palavras, número de verbos e velocidade de fala. Não houve diferença no desempenho pré e pós tratamento na produção escrita. Conclusão: Tanto a aprendizagem implícita como a explícita têm o potencial de serem usadas no tratamento do agramatismo. A Mapping Therapy foi mais eficaz no tratamento do agramatismo na produção escrita, enquanto o ORLA foi mais eficaz para o agramatismo na produção oral.
Asunto(s)
Humanos , Afasia , Afasia de Broca , Rehabilitación , AprendizajeRESUMEN
Agrammatism is characterized by morphosyntactic deficits in production of sentences. Studies dealing with the treatment of these deficits are scarce and their results controversial. The present study describes the rehabilitation of a case diagnosed as chronic Broca?s aphasia, with agrammatism, using a method directed to sentence structural deficits. The method aims to expand the grammatical repertoire by training production of sentences with support from contexts that stimulate actions and dialogues. The patient showed positive results on all types of sentences trained and generalized the gains to spontaneous speech. However, these benefits were not sustained in the long term.
O agramatismo é marcado por déficits morfossintáticos na produção das sentenças. Estudos que abordam o tratamento destas dificuldades são escassos e controversos. O presente estudo descreveu a reabilitação de uma paciente com agramatismo associado à afasia de Broca em fase crônica, por meio de programa de estruturação de sentenças. Trata-se de método que visa à expansão do repertório gramatical através do treino com apoio de contextos que estimulam ações e diálogos. A paciente obteve resultados positivos em todos os tipos de frases treinadas, com ganhos generalizados para contextos de fala espontânea. No entanto, os benefícios não se mantiveram em longo termo.
Asunto(s)
Humanos , Afasia , Afasia de Broca , RehabilitaciónRESUMEN
Objective To investigate question comprehension and production among agrammatic aphasics, and to explore the mechanisms of any dysfunction in questioning.Methods Twenty aphasics were recruited in this study.According to the Chinese Agrammatism Battery,10 were classified as agrammatic (the agrammatic group) and 10 as non-agrammatic (the non-agrammatic group).Ten normal subjects served as a control group.All the subjects were tested in terms of their comprehension and production of questions using a set of general and what-where-who- why questions (wh-questions).Results No significant difference was found between the two experimental groups with regard to the correct comprehension and production of both general and wh-questions.However,there was a sig- nificant difference in correctness between comprehension and production.The performance of the agrammatic aphasics was worse than that of the non-agramatics and the normal subjects.Conclusion The impaired question comprehen- sion and production of Chinese agrammatic aphasics has its own characteristies which can form a basis for rehabilita- tion planning and outcome prediction.
RESUMEN
Objective To provide a theoretical foundation for language rehabilitation by investigating the characteristics of verb impairment in Chinese agrammatism(CA)and exploring its mechanism.Methods Fifteen CA patients and 15 normal subjects(control group)were recruited and evaluated using a standardized aphasia battery in Chinese,the Chinese agrammatism battery,a verb comprehension and production task and a short-term memory task.Results Compared with the control group,verb comprehension and production,as well as working memory were significantly damaged among the CA patients,and it was more difficult for the agrammatic aphasics to produce than to comprehend verbs(P＜0.01).Verbs with a more complex argument structure(in terms of the number and type of arguments)were more difficult for the agrammatie aphasics to produce than those with a less complex argu- ment structure.But the complexity of the argument structure did not influence the agrammatic aphasics'verb compre- hension.Conclusion The semantic entry of a verb,shared by both comprehension and production,was intact,but the verb's grammar entry was impaired.Poor working memory together with the complexity of the argument structure accounted for the impaired verb production of the agrammatic patients.